Narcolepsy related report
Narcolepsy is a physiological disorder, which generally occurs in the age of 15 ~ 30, but some people have narcolepsy sooner or later. Sleepiness is difficult to eradicate completely. Men and women are equally affected, and once they appear, they may accompany them for life. Sleepiness is difficult to diagnose. Its initial symptoms are usually severe daytime sleepiness. There are many reasons for this symptom, so it usually takes several years to diagnose the patient with this disease.
main feature
(1) Too much sleep or sleep attack during the day can't be explained by lack of sleep time, and the transition time from waking to full waking is prolonged; Sleepiness performance
(2) This kind of sleep disorder occurs every day for more than 1 month or has repeated sleep attacks, causing obvious distress or affecting work or family life. (3) Eliminate daytime sleepiness and narcolepsy caused by various organic diseases. The onset of narcolepsy is mostly related to psychological factors. [2]
cardinal symptom
Narcolepsy is defined as four main symptoms in medicine, which are called sleep tetralogy: sleep attack is the most obvious symptom of narcolepsy, and patients will feel refreshed after sleep attack. Sudden refers to the sudden loss of muscle tension in a fully awake state, leading to paralysis of the head or body without losing consciousness. It can last for a few seconds or minutes. Mild symptoms are slurred speech, stuttering, drooping eyelids or inability to hold things with your fingers. Severe cataplexy can lead to knee bending and make people collapse. Laughter, excitement or anger are typical causes of cataplexy, and the sudden relaxation of muscle mass may be the result of the brain suddenly falling into REM sleep. Cataplexy is not very common, and less than half of narcolepsy patients have cataplexy. Sleep paralysis is a symptom that people are temporarily unable to exercise when they fall asleep or want to wake up. It only lasts a few minutes. Similar to cataplexy, sleep paralysis may also be related to insufficient transition between REM sleep and waking state. Hypnotic hallucination refers to the image of spirit and dream, which is usually horrible and usually occurs during sleep or before sleep paralysis. For teenagers or just adults, these symptoms have never appeared before, and usually appear suddenly. People suffering from narcolepsy will complain that they feel tired easily and perform poorly in work, study and social activities. Excessive sleepiness during the day will make people lose their due ability and reduce their memory, thus greatly reducing their quality of life, and the visual impairment caused by sleepiness may be particularly disturbing. More than half of the people who are sleepy will have memory loss or memory interruption at the same time, which is caused by "micro-sleep" that breaks into the awake state. At these stages, people with drowsiness will be at a loss, babble or scribble, and put things wrong or bump into things when walking or driving. Usually, they can't control their behavior at these stages, and they don't remember what happened later. [3]
Sleepiness is a common clinical symptom, so how much do you know about the causes of sleepiness? 1, sleep-induced respiratory disorders such as sleep apnea syndrome; 2. Sleepiness; 3. Excessive physical activity during sleep (such as excessive physical activity or grinding teeth); 4. Depression; 5. Sleepiness after virus infection; 6. Head trauma; 7. Sleepiness caused by toxins or drugs of metabolic diseases; 8. Sleepiness caused by unknown reasons; 9, lack of sleep; 10, circadian biological rhythm disorder; If you find some drowsiness caused by internal factors, you will prescribe the right medicine. If it is caused by other external factors, the doctor will adjust the patient's sleep habits for treatment [4]
Narcolepsy can be diagnosed by the occurrence of typical stages and the results of all-night sleep research in multistage sleep latency test. Sleep research can verify other causes of daytime sleepiness, such as sleep deprivation, sleep apnea and depression. The latent test of multi-level sleep is conducted in the sleep research institute, usually after sleep. Some people electronically control brain waves, eye movements, muscle activity, heartbeat, blood oxygen level and breathing by using polysomnography equipment. This kind of test is usually done after getting enough sleep at night, so the results are clearer. UK 15-year-old girls can sleep for two weeks because of narcolepsy.
The multi-level sleep latency test includes four 20-minute siesta opportunities, with an interval of two hours, evenly distributed throughout the day. Sleepy people can fall asleep in about 5 minutes or less, and at least two of the four naps will transition to REM sleep. In contrast, normal people generally need 12 ~ 14 minutes to fall asleep, and they will not enter the REM sleep stage during such a nap.
Narcolepsy test
The Sleepiness Scale (ess) scores whether there is a nap in the following situations: sitting while reading, sitting still in public places (such as theaters or conferences), sitting by car for a long time without rest (1 hour or more), sitting while talking with people, resting after meals (when not drinking), driving in the afternoon and other traffic lights. Note: ① Scoring standard: never. Rarely = 1 min; Sometimes =2 points; Often =3 points; ② If the total score exceeds 9, you may feel sleepy. The measuring table is a common means and method for diagnosing narcolepsy in clinic.
treat cordially
general treatment
Mainly adjust from the law of life. First of all, we should take part in sports activities for at least one hour every day to get excited physically and mentally. Secondly, take part in more group activities, such as singing and social activities. Thirdly, we should have a positive attitude towards life, make a good life study plan for ourselves every day and work hard to complete it.
medicine
The main goal is to control patients' symptoms and improve their quality of life. (1), improving daytime sleepiness can be treated by taking stimulants such as toluene salt (ritalin and other trade names) or dextroamphetamine, and taking a regular nap during the day. (2) Eliminate cataplexy and sleep paralysis. Patients with cataplexy and sleep paralysis can be treated with tricyclic antidepressants. It can also be treated by taking sodium hydroxybutyrate, because the side effects of this drug are special and must be applied under the guidance of a doctor. (3) It is very important to adjust mental state for psychological consultation on issues related to self-esteem and emotional support, especially those who are sleepy, because they can't give full play to their potential, and may be considered lazy by their families and peers and unwilling to exercise. In this case, psychotherapy is often used to eliminate the adverse psychological factors related to the onset, avoid mental stimulation, and help patients establish a normal life rule. In addition, small doses of psychotropic drugs, such as amphetamine and methylphenidate, can be given and applied under the guidance of a doctor when necessary. (4) Chinese medicine therapy: deficiency of both qi and blood: physical weakness, qi deficiency, laziness, fatigue, dizziness, palpitation and uneasiness. Less menstrual flow, light color and thin quality. I feel sleepy when I walk, especially after eating. Pale face, pale tongue with white fur and weak pulse. Treatment should benefit qi and nourish blood. The preferred prescription: Shiquan Dabu Decoction. Codonopsis pilosula, Atractylodis Rhizoma, Poria, Radix Rehmanniae Preparata, Radix Angelicae Sinensis and Radix Paeoniae Alba each 10g, Radix Astragali 15g, Rhizoma Chuanxiong 6g, Cortex Cinnamomi and Radix Glycyrrhizae 3g. If the spleen is deficient, Xiangsha Liujunzi Decoction is the first choice to strengthen the spleen and replenish qi; If blood deficiency is obvious, Paeonia lactiflora and Angelica sinensis should be supplemented with Colla Corii Asini (chemical) 10g to nourish blood. Acorus gramineus, Alpinia oxyphylla and other drugs can be added to the prescription to enlighten and refresh. Spleen deficiency and dampness: obesity, often accompanied by edema, wheezing when moving, loss of appetite, stuffy stomach, frequent leucorrhea, and thick texture. Mental fatigue, top-heavy, drowsy all day, lethargy. White greasy tongue coating and slow pulse. Treatment should be dampness-removing, spleen-strengthening, qi-invigorating and refreshing. The preferred prescription is Taiwushenshu Powder (medical prescription set): Rhizoma Atractylodis, Pericarpium Citri Tangerinae 65,438+02g, Herba Agastaches, Cortex Magnolia Officinalis, Rhizoma Acori Graminei 65,438+00g, Rhizoma Zingiberis Recens 6g, and Fructus Jujubae 65,438+00. For those with damp pathogen, yellow urine and greasy tongue coating, it is advisable to reduce the dosage of products for drying and promoting qi, and add Scutellaria baicalensis Georgi 65438 00 g, Gardenia 65438 00 g, Coicis Semen 65438 00 g, and medulla Tetrapanacis 6g to clear away heat and dry dampness. Such patients should add the dosage of Acorus gramineus as appropriate to refresh their minds. Deficiency of kidney essence: menstrual fatigue, good sleep, tinnitus and deafness, and dull expression. I am very tired on weekdays, and my waist and knees are weak. Late menstruation, less menstrual flow. The tongue is pale and the pulse is heavy and thin. Treatment should benefit kidney and replenish essence. The preferred prescription: Heche Jujube Pill. This medicine is available. The elderly can see cold limbs and frequent nocturnal urination due to kidney-yang deficiency. You can add12g epimedium and 6 restraint aconite root, or change Gui You pill to treat serious diseases with common therapies of yin and yang. That also requires symptomatic treatment, which may not be suitable for every patient. Therefore, to treat narcolepsy, we should find a professional treatment institution. At the same time of treatment, patients are advised to pay more attention to diet and keep their daily life reasonable and normal. Li XX, male, age 18, a successful case of narcolepsy treated by traditional Chinese medicine, is a high school student. His father is an expert in thoracic surgery and his mother is an expert in gynecology. 1978 10 His father invited me to make house calls at home. When the patient entered the room, he was fast asleep and he was forced to wake him up. Seeing that his spirit seemed bright and sleepy, he was speechless, took his pulse and fell asleep again. Mother said that the patient had slept for five days. Because of the college entrance examination, I was exhausted, and I was caught in the rain on my way home. It was diagnosed as neurasthenia by people's hospital. After taking western medicine for 4 days, it didn't get better. Instead, it aggravated sleepiness day and night, didn't think about diet, didn't defecate for 3 days, urinated Huang Chi, had a dark tongue and thick and greasy fur. Etiology and pathogenesis analysis: the patient is overworked, weak in vital qi, and after being caught in the rain, wet turbidity invades by taking advantage of deficiency, which makes him blind and sleepy. Treatment rule: aromatic dampness, spleen awakening and resuscitation. Prescription: Modified "Xingpi Kaiqiao Decoction". After taking three doses, the patient's drowsiness symptoms were relieved, he could eat three meals a day on time, and he was energetic to chat with his family, but he was still weak in speaking. Astragalus membranaceus 15g and Atractylodes macrocephala 12g were added according to the original prescription, and 6 doses were taken continuously. Completely back to normal. The patient's family is very tall, and the brows that have been locked for many days have finally loosened. His father said: "I didn't expect Chinese medicine to be so magical and cure my son's illness so quickly." Thank you very much A year later, his father came to see me with another patient. I asked about his son. He said everything was fine, and he was never sick again. Now his son is studying in Beijing. Live regularly and overcome drowsiness. First of all, we must grasp the rhythm of life. Don't stay up late to study, go to bed early and get up late. We should form more regular living habits. Practice has proved that it is the key to relieve sleepiness to adjust the living habits formed in winter and make the body gradually adapt to the climate with rising temperature. For example, in order to keep warm in winter, the door is usually closed, and in spring, the doors and windows should be opened frequently to make the indoor air unobstructed; We should also pay attention to ensuring a certain amount of sleep time in our daily life. Adequate sleep helps to eliminate fatigue. More exercise helps to prevent narcolepsy.
In the spring of the earth, everything is revived. We should go outdoors more and do some proper fitness exercises, which can effectively improve physiological functions, increase human respiratory and metabolic functions, accelerate internal circulation, increase oxygen supply to the brain and relieve drowsiness. For example, taking a walk in the morning, doing exercises, running and playing Tai Ji Chuan are all very conducive to refreshing. According to modern medical research, sleepiness is related to protein deficiency, acidic environment and insufficient vitamin intake. Therefore, we should pay attention to increasing protein's intake in spring sleep, such as increasing fish, eggs, milk, bean products, pork liver, chicken, peanuts and other foods.
Edit this paragraph. What diseases are narcolepsy easily confused with?
1) narcolepsy. The disease is usually accompanied by one or more additional symptoms, such as cataplexy, sleep paralysis and hallucinations before falling asleep; Sleep attacks are irresistible; Sleep at night is fragmented and time is shortened. On the contrary, narcolepsy occurs less frequently during the day, but lasts longer; Patients can often prevent it from happening; Sleep at night is usually prolonged. 2) Sleep apnea. Narcolepsy related to sleep apnea, such patients not only have symptoms of excessive sleep during the day, but also have a history of nocturnal apnea, typical intermittent snoring, obesity, hypertension, cognitive impairment, hyperhidrosis and hyperactivity at night, headache in the morning and dyskinesia. The onset time and duration of apnea can be determined by the records of sleep laboratory. The above is not difficult to distinguish from narcolepsy. 3) Organic diseases accompanied by mental diseases such as lethargy, encephalitis, meningitis and concussion, metabolic disorders, poisoning, endocrine abnormalities, post-radiation syndrome, etc. Can cause narcolepsy. Through medical history, physical examination, clinical observation and corresponding laboratory examination, it is definitely diagnosed as sleepiness caused by organic diseases, so the diagnosis of (non-organic) sleepiness should not be considered. [9]
Edit this paragraph about the causes of narcolepsy.
1, sleep-induced respiratory disorders such as sleep apnea syndrome; 2. Sleepiness; 3. Excessive physical activity during sleep (such as excessive physical activity or grinding teeth); 4. Depression; 5. Sleepiness after virus infection; 6. Head trauma; 7. Sleepiness caused by toxins or drugs of metabolic diseases; 8. Sleepiness caused by unknown reasons; 9, lack of sleep; 10, circadian biological rhythm disorder [10]